Individual
LESLIE A HECKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
111 S JEFFERSON STREET, GREEN BAY, WI 54301
(920) 448-6155
(920) 448-6177
Mailing address
111 S JEFFERSON STREET, GREEN BAY, WI 54301
(920) 448-6155
(920) 448-6177
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
856123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39719200
—
WI
Enumeration date
04/09/2008
Last updated
04/09/2008
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